Ultraviolet-C decontamination of a hospital room: Amount of UV light needed

Coverage Planning for UVC Irradiation: Robot Surface Disinfection Based on Swarm Intelligence Algorithm

Ultraviolet (UV) radiation has been widely utilized as a disinfection strategy to effectively eliminate various pathogens. The disinfection task achieves complete coverage of object surfaces by planning the motion trajectory of autonomous mobile robots and the UVC irradiation strategy. This introduces an additional layer of complexity to path planning, as every point on the surface of the object must receive a certain dose of irradiation. Nevertheless, the considerable dosage required for virus inactivation often leads to substantial energy consumption and dose redundancy in disinfection tasks, presenting challenges for the implementation of robots in large-scale environments. Optimizing energy consumption of light sources has become a primary concern in disinfection planning, particularly in large-scale settings. Addressing the inefficiencies associated with dosage redundancy, this study proposes a dose coverage planning framework, utilizing MOPSO to solve the multi-objective optimization model for planning UVC dose coverage. Diverging from conventional path planning methodologies, our approach prioritizes the intrinsic characteristics of dose accumulation, integrating a UVC light efficiency factor to mitigate dose redundancy with the aim of reducing energy expenditure and enhancing the efficiency of robotic disinfection. Empirical trials conducted with autonomous disinfecting robots in real-world settings have corroborated the efficacy of this model in deactivating viruses.

Research progress of fullerenes and their derivatives in the field of PDT

In contemporary studies, the predominant utilization of C60 derivatives pertains to their role as photosensitizers or agents that scavenge free radicals. The intriguing coexistence of these divergent functionalities has prompted extensive investigation into water-soluble fullerenes. The photodynamic properties of these compounds find practical applications in DNA cleavage, antitumor interventions, and antibacterial endeavors. Consequently, photodynamic therapy is progressively emerging as a pivotal therapeutic modality within the biomedical domain, owing to its notable levels of safety and efficacy. The essential components of photodynamic therapy encompass light of the suitable wavelength, oxygen, and a photosensitizer, wherein the reactive oxygen species generated by the photosensitizer play a pivotal role in the therapeutic mechanism. The remarkable ability of fullerenes to generate singlet oxygen has garnered significant attention from scholars worldwide. Nevertheless, the limited permeability of fullerenes across cell membranes owing to their low water solubility necessitates their modification to enhance their efficacy and utilization. This paper reviews the applications of fullerene derivatives as photosensitizers in antitumor and antibacterial fields for the recent years.

Shedding light on the problem: Influence of the radiator power, source-sample distance, and exposure time on the performance of UV-C lamps in laboratory and real-world conditions

Effective surface disinfection is crucial for preventing the spread of pathogens in hospitals. Standard UltraViolet-C (UV-C) lamps have been widely used for this purpose, but their disinfection efficiency under real-world conditions is not well understood. To fill this gap, the influence of the power of the ultraviolet radiator, source-sample distance, and exposure time on the performance of UV-C lamps against Escherichia coli and Staphylococcus epidermidis were experimentally determined in the laboratory and hospital. The obtained results showed that the UV irradiance and, thus, the UV-C disinfection efficiency decreased significantly at distances greater than 100 cm from the UV-C lamp. Moreover, increasing the total power of the radiators does not improve the performance of UV-C lamps under real conditions. The UV-C disinfection efficiency greater than 90% was achieved only under laboratory conditions at a close distance from the UV-C lamp, i.e., 10 cm. These findings provide novel insights into the limitations of UV-C lamps in real-world conditions and highlight the need for more effective disinfection strategies in hospitals.

UVC Box: An Effective Way to Quickly Decontaminate Healthcare Facilities' Wheelchairs

Disinfection in the hospital environment remains challenging, especially for wide and structurally complex objects such as beds or wheelchairs. Indeed, the regular disinfection of these objects with chemicals is manually carried out by healthcare workers and is fastidious and time-consuming. Alternative antibacterial techniques were thus proposed in the past decades, including the use of naturally antimicrobial UVC. Here, the antibacterial efficiency of a large UVC box built to accommodate wheelchairs was investigated through testing bacterial burden reductions on various parts of a wheelchair, with various support types and with several treatment durations. The results demonstrate a time-dependent antibacterial effect, with a strong burden reduction at only five minutes of treatment (>3-log median reduction in Escherichia coli and Staphylococcus epidermidis). The UVC flux and residual bacterial burden both significantly varied depending on the spatial location on the wheelchair. However, the nature of the support impacted the antibacterial efficiency even more, with residual bacterial burdens being the lowest on rigid materials (steel, plastics) and being the highest on tissue. On metallic samples, the nature of the alloy and surface treatment had various impacts on the antibacterial efficiency of the UVC. This study highlights the efficiency of the tested UVC box to efficiently and quickly decontaminate complex objects such as wheelchairs, but also gives rise to the warning to focus on rigid materials and avoid porous materials in the conception of objects, so as to ensure the efficiency of UVC decontamination.

Scoping review on the efficacy of filter and germicidal technologies for capture and inactivation of micro-organisms and viruses

The COVID-19 (SARS-CoV-2) pandemic increased the focus on preventing contamination with airborne pathogens (e.g. viruses, bacteria, and fungi) by reducing their concentration. Filtration, UV or ionization technologies could contribute to air purification of the indoor environment and inactivation of micro-organisms. The aim of this study was to identify the relevant literature and review the scientific evidence presented on the efficacy of filter and germicidal technologies (e.g. non-physical technologies) in air purification applications used to capture and inactivate micro-organisms and airborne viruses (e.g. SARS-CoV-2, rhinovirus, influenzavirus) in practice. A scoping review was performed to collect literature. Adopting exclusion criteria resulted in a final number of 75 studies to be included in this research. Discussion is presented on inactivation efficiencies of ultraviolet germicidal irradiation (UVGI) and ionization applications in laboratory studies and in practice. Specific attention is given to studies relating the use of UVGI and ionization to inactivation of the SARS-CoV-2 virus. Based on the consulted literature, no unambiguous conclusions can be drawn regarding the effectiveness of air purification technologies in practice. The documented and well-controlled laboratory studies do not adequately represent the practical situation in which the purifier systems are used.

Disinfection and sterilization: New technologies

BACKGROUND

Adherence to professional guidelines and/or manufacturer's instructions for use regarding proper disinfection and sterilization of medical devices is crucial to preventing cross transmission of pathogens between patients. Emerging pathogens (e.g., Candida auris) and complex medical devices provide new challenges.

METHODS

A search for published English articles on new disinfection and sterilization technologies was conducted by Google, Google scholar and PubMed.

RESULTS

Several new disinfection methods or products (e.g., electrostatic spraying, new sporicides, colorized disinfectants, "no touch" room decontamination, continuous room decontamination) and sterilization technologies (e.g., new sterilization technology for endoscopes) were identified.

CONCLUSIONS

These technologies should reduce patient risk.

The effectiveness of phototherapy for surface decontamination against SARS-Cov-2. A systematic review

COVID-19 appeared in December 2019, needing efforts of science. Besides, a range of light therapies (photodynamic therapy, ultraviolet [UV], laser) has shown scientific alternatives to conventional decontamination therapies. Investigating the efficacy of light-based therapies for environment decontamination against SARS-CoV2, a PRISMA systematic review of Phototherapies against SARS-CoV or MERS-CoV species discussing changes in viral RT-PCR was done. After searching MEDLINE/PubMed, EMBASE, and Literatura Latino-Americana e do Caribe em Ciências da Saúde we have found studies about cell cultures irradiation (18), blood components irradiation (10), N95 masks decontamination (03), inanimate surface decontamination (03), aerosols decontamination (03), hospital rooms irradiation (01) with PDT, LED, and UV therapy. The best quality results showed an effective low time and dose UV irradiation for environments and inanimate surfaces without human persons as long as the devices have safety elements dependent on the surfaces, viral charge, humidity, radiant exposure. To interpersonal contamination in humans, PDT or LED therapy seems very promising and are encouraged.

Development and Demonstration of a Wireless Ultraviolet Sensing Network for Dose Monitoring and Operator Safety in Room Disinfection Applications

The use of mobile ultraviolet-C (UV-C) disinfection devices for the decontamination of surfaces in hospitals and other settings has increased dramatically in recent years. The efficacy of these devices relies on the UV-C dose they deliver to surfaces. This dose is dependent on the room layout, the shadowing, the position of the UV-C source, lamp degradation, humidity and other factors, making it challenging to estimate. Furthermore, since UV-C exposure is regulated, personnel in the room must not be exposed to UV-C doses beyond occupational limits. We proposed a systematic method to monitor the UV-C dose administered to surfaces during a robotic disinfection procedure. This was achieved using a distributed network of wireless UV-C sensors that provide real-time measurements to a robotic platform and operator. These sensors were validated for their linearity and cosine response. To ensure operators could safely remain in the area, a wearable sensor was incorporated to monitor the UV-C exposure of an operator, and it provided an audible warning upon exposure and, if necessary, ceased the UV-C emission from the robot. Enhanced disinfection procedures could then be conducted as items in the room could be rearranged during the procedure to maximise the UV-C fluence delivered to otherwise inaccessible surfaces while allowing UVC disinfection to occur in parallel with traditional cleaning. The system was tested for the terminal disinfection of a hospital ward. During the procedure, the robot was manually positioned in the room by the operator repeatedly, who then used feedback from the sensors to ensure the desired UV-C dose was achieved while also conducting other cleaning tasks. An analysis verified the practicality of this disinfection methodology while highlighting factors which could affect its adoption.

Antimicrobial efficacy and inactivation kinetics of a novel LED based UV-irradiation technology

BACKGROUND

UV light emitting diodes (UV-LEDs) are energy efficient and of special interest for the inactivation of microorganisms. In context of the current pandemic, novel UV technologies can offer a powerful alternative of effective infection prevention and control (IPC).

METHODS

We here assessed the antimicrobial efficacy of UV-C LEDs on Escherichia coli, Pseudomonas fluorescens and Listeria innocua as well as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), human immunodeficiency virus 1 (HIV-1) and murine norovirus (MNV) dried on inanimate surfaces based on the European standard EN 17272.

RESULTS

We found an inactivation rate of 90% for the tested bacteria at a mean UV-C dose, averaged over all three investigated UV-C wavelengths, of 1.7 mJ cm^-2 for E. coli, 1.9 mJ cm^-2 for P. fluorescens and 1.5 mJ cm^-2 for L. innocua. For the tested viruses, a 90% inactivation rate at UV doses less than 15 mJ cm^-2 for applied UV wavelengths at 255 nm and 265 nm were found. Exposure of viruses to longer UV wavelengths such as 275 nm and 285 nm, required much higher doses up to 120 mJ cm^-2 for inactivation. Regarding inactivation, non-enveloped MNV required much higher UV doses for all tested wavelengths compared to SARS-CoV-2 or HIV-1.

CONCLUSION

Overall, our data recommend the use of LEDs emitting at shorter wavelengths of the UV-C spectrum to inactivate bacteria as well as enveloped and non-enveloped viruses by exposure to the appropriate UV-dose. However, low availability and excessive production costs of shortwave UV-C LEDs restricts the implementation currently and supports the use of longwave UV-C LEDs in combination with higher irradiation doses.

Porcine embryo development and inactivation of microorganisms after ultraviolet-C irradiation at 228 nm

It is important to prevent contamination inside the incubator as a method of preventing microbial infections during the embryo culture. In the present study, we examined the effects of ultraviolet-C (UV-C) irradiation, used for microorganism inactivation, on embryo development and the growth of bacteria, including Escherichia coli and Staphylococcus aureus, and the fungus Cladosporium cladosporioides. In the embryo irradiation experiment, we examined the effects of the plastic lid of the culture dish, irradiation distances (10, 20, and 25 cm), and different irradiation wavelengths (228 and 260 nm) during embryo culture for 7 days on the development and quality of porcine in vitro-fertilized embryos. None of the embryos cultured in dishes without plastic lids developed into blastocysts after irradiation with 228 nm UV-C. When porcine embryos were cultured in a culture dish with lids, the 228 nm UV-C irradiation decreased blastocyst formation rates of the embryos but not their quality, irrespective of the UV-C irradiation distance. Moreover, irradiation with 260 nm UV-C, even with plastic lids, had more detrimental effects on embryo development than irradiation with 228 nm UV-C. Investigation of the inactivating effects of UV-C irradiation at 228 nm and 260 nm on the growth of the bacteria and fungus showed that 260 nm UV-C reduced the viability to a greater extent than 228 nm UV-C. Moreover, the disinfection efficacy for the bacteria increased when the irradiation duration increased and the distance decreased. In conclusion, porcine embryos can develop into blastocysts without loss of quality even after continuous long-duration irradiation (7 days) with 228 nm UV-C, which can inactivate the growth of bacteria and the tested fungus; however, the development rate of the embryo is reduced.

Disinfection of Virtual Reality Devices in Health Care Settings: In Vitro Assessment and Survey Study

BACKGROUND

Virtual reality (VR) devices are increasingly used in health care settings. The use among patients has the potential to unintentionally transmit pathogens between patients and hospital staff. No standard operating procedure for disinfection exists to ensure safe use between patients.

OBJECTIVE

This study aims to determine the efficacy of disinfectants on VR devices in order to ensure safe use in health care settings.

METHODS

Three types of bacteria were inoculated onto porous and nonporous surfaces of 2 VR devices: the Meta Oculus Quest and Meta Oculus Quest 2. Disinfection was performed using either isopropyl alcohol or alcohol-free quaternary ammonium wipes. A quantitative culture was used to assess the adequacy of disinfection. A survey was separately sent out to VR device technicians at other pediatric health care institutes to compare the methods of disinfection and how they were established.

RESULTS

Both products achieved adequate disinfection of the treated surfaces; however, a greater log-kill was achieved on nonporous surfaces than on the porous surfaces. Alcohol performed better than quaternary ammonium on porous surfaces. The survey respondents reported a wide variability in disinfection processes with only 1 person reporting an established standard operating procedure.

CONCLUSIONS

Disinfection can be achieved through the use of either isopropyl alcohol or quaternary ammonium products. Porous surfaces showed lesser log-kill rates than the nonporous surfaces, indicating that the use of an added barrier may be of benefit and should be a point of future research. Given the variability in the disinfection process across health care systems, a standard operating procedure is proposed.

Photodegradation of free estrogens driven by UV light: Effects of operation mode and water matrix

Estrogens are endocrine disrupting chemicals that have been frequently detected in diverse water matrices (e.g. surface water, wastewater and drinking water) and caused a series of health risks. This study was aimed at investigating the photochemical degradation of free estrogens estrone (E1), 17β-estradiol (E2), estriol (E3), and 17α-ethyl estradiol (EE2) upon the monochromatic irradiation (253.7 nm). Concerning the practical installation of photolysis treatment, exposing the impacts of photoreactor operation mode (stationary or up-flow) and the water matrix (ultrapure water or natural surface water) on the photolytic behaviour of estrogens was of high importance. The pseudo-first-order rate constants showed that E1 was the most susceptible to UV radiation among chosen estrogens due to its high molar absorption coefficient of 402.4 M^-1 cm^-1 and quantum yield of 0.065 mol E^-1 at λ = 253.7 nm. Moreover, the up-flow mode and the surface water matrix collected from a lake in Regent's Park (London) were found to favour the photodegradation of estrogens due to the introduction of more dissolved oxygens and promotion of reactive oxygen species (ROS) formation. These findings may shed light on the photochemical behaviour of estrogens in some specific scenarios.

Protocol for Evaluating the Microbial Inactivation of Commercial UV Devices on Plastic Surfaces

With the plethora of commercially available UV-C devices exhibiting different intensity and lifespans, it is critical to consumer safety that companies verify and clearly communicate the efficacy of their devices as per the intended use. The purpose of this study was to define a low-cost protocol for investigating the antimicrobial efficacy of commercial UV devices for industry use. The tested devices included: a wall-mounted unit (Device A), a troffer unit (Device B), and an induction lamp unit (Device C). The devices were installed within an enclosed tower to prevent the transmission of UV-C radiation outside of the testing area. The procedure details determining the devices' antimicrobial efficacy using plastic coupons inoculated with Escherichia coli or Staphylococcus aureus. The protocol includes suggested time-distance treatments according to the potential application of each device type and reports the results as log CFU/mL reduction or percent reduction.

Improvement and standardization of disinfection in Hospital Theatre with UV-C technology

BACKGROUND

The level of disinfection between operating sessions is important to prevent cross-contamination risk in Operating Theatres (OTs). The aim was to assess the difference in microbial contamination between different disinfection levels (DLs), before T(0) and after T(1) application of a UVC Device (UVC-D).

METHODS

A cross-sectional study was conducted between December 2019 and August 2020 in a Clinic. Three DLs: no disinfection after surgery (DL0), after in-between cleaning (DL1), and after terminal cleaning (DL2), were compared to assess the reduction of microbial presence before T(0) and after T(1), the use of UVC-D that was used for 5-3 minutes per bedside. 260 Petri dishes (PD), divided into a preliminary phase followed by a probabilistic model-driven experiment, were used in 3 OTs, and Colony Forming Units (CFU) were counted. The Mann-Whitney test was performed in the preliminary phase to establish UVC exposure time. Using the probabilistic model, we calculated descriptive statistics and % and log₁₀ reduction. The MANOVA analysis for repeated measure was performed to verify the 95% statistical difference between T(0) and T(1), combined with the DLs and different OTs.

RESULTS

The Mann-Whitney showed no CFU difference between 3-5 minutes of UVC exposure time; the MANOVA test for showed no significant difference between DLs in T(0)-T(1) CFU reduction with a mean CFU reduction of 72% (CI95% 61.7 - 84.9%) regardless of the DL applied before.

CONCLUSION

UVC-D enhanced environmental disinfection under any initial conditions. In concert with sainting procedures improves and standardizes the level of environmental hygiene.

Photocatalytic oxidation conveyor "PCOC" system for large scale surface disinfection

In this paper, we present a surface decontamination system that substitutes traditional chemicals and scrubbing agents, which will be useful for the general public during a pandemic. The technique is based on a hybrid process in which UV-C light and its photons interact with metal oxide nano-catalysts to generate hydroxyl radicals, which can enhance the deactivation process, and the system can work even in the shadow regions via a dry process. The optimum number of UV light sources in combination with TiO₂ nanoparticles catalysts on aluminum plates have been used synergistically in the system. The UV dose in the disinfection chamber has been optimized, which is between 60 and 500 mJ/cm² throughout the disinfection chamber. The concentration of hydroxyl radicals is reported more than 25 000 ions/cm³ within the disinfection chamber. These ions are circulated throughout the disinfection volume. The disinfection efficiency has been tested on bacteria and spores, and the obtained results are correlated. Around 8 log reductions in the counts of the test bacteria of Escherichia coli and Klebsiella pneumoniae have been achieved in just 2 min of exposure in the continuous operation of the system. Tests have also been performed on Geobacillus stearothermophilus spores, and the method described here is the result of multiple tests, a review of the scientific literature, and the incorporation of current laboratory practice. The deactivation tested in the system is larger than that of known bacteria and viruses in terms of UV-doses, signifying its utility during the pandemic.

Filtration efficiency of N95 filtering facepiece respirators during multi-cycles of “8-hour simulated donning + disinfection”

Background

Aerosol-borne diseases such as COVID-19 may outbreak occasionally in various regions of the world, inevitably resulting in short-term shortage and corresponding reuse of disposable respirators.

Aim

To investigate the effective disinfection methods, reusable duration and frequency of N95 respirators.

Methods

Based on the self-built respirator simulation test system, and under combinations of experimental conditions of three N95 respirators × 0–200 nm NaCl aerosols × three simulated breathing flow rates (15, 50 and 85 L/min) × two disinfection methods (dry heating and ultraviolet (UV) radiation), this study continuously measured the changes in filtration efficiency of all respirators during multi-cycles of ‘8-h simulated donning + disinfection’ until the penetration reached ≥5%.

Findings

Multi-cycles of dry heating and UV radiation treatments on the reused (i.e., multiple 8-h donning) N95 respirators had a minimal effect (<0.5%) on the respirator filtration efficiency, and even at 85 L/min, all tested N95 respirators were able to maintain filtration efficiencies ≥95% for at least 30 h or four reuse cycles of ‘8-h donning + disinfection’, while a lower breathing flow rate (15 L/min) plus the exhalation valve could further extend the N95 respirator's usability duration up to 140 h or 18 reuse cycles of ‘8-h donning + disinfection’. As the respirator wearing time extended, aerosol penetration slowly increased in a quadratic function with a negative second-order coefficient, and the penetration increment during each cycle of 8-h donning was less than 0.9%.

Conclusion

Multi-cycles of N95 respirator reuse in combination with dry heating or UV irradiation disinfection are feasible.

Ultraviolet-C Light-emitting Device Against Microorganisms in Beauty Salons

Background.

Ultraviolet light in the UV-C band is also known as germicidal radiation, and it is widely used for decontamination and disinfection of environments, water, and food. The ultraviolet source transfers electromagnetic energy from a mercury arc lamp to an organism's genetic material. When UV radiation penetrates the cell wall of an organism, it destroys the cell's ability to reproduce, through a physical and not chemical process. Thus, the objective of this study was to evaluate the antimicrobial potential of a new UV-C generating device (Asepsis) against clinically important microorganisms that may be present in beauty centers.

Methods.

We present here a set of tests performed on tools easy to find in beauty salons (hair-brushes, nail pliers, makeup brushes, and, due to the recent COVID-19 pandemic, face mask samples). They were individually contaminated with bacteria (Pseudomonas aeruginosa, Staphylococcus aureus), fungi (Microsporum canis, Trichophyton rubrum, Candida albicans, Malassezia furfur), and the Chikungunya virus. Different times of exposure were evaluated (1, 3, and 5 minutes).

Results.

There was notable reduction in the microbial load in every test, in comparison with control groups. Best results were observed on face mask samples, while the makeup brush showed less reduction, even with longer periods of exposure.

Conclusions.

Beauty salons present a risk of infections due to microbial exposure. The device tested can efficiently inactivate, in a short time, microorganisms contaminating most tools found in this setting. The device also showed promising results against enveloped virus.

Comparative investigation of toxicity induced by UV-A and UV-C radiation using Allium test

Organisms are increasingly exposed to ultraviolet (UV) rays of sunlight, due to the thinning of the ozone layer and its widespread use in sterilization processes, especially against the SARS-CoV-2 virus. The present study was conducted with the purpose of evaluating the damages of UV-A and UV-C radiations in Allium cepa L. roots. The effects of two different types of UV on some physiological, biochemical, cytogenotoxic, and anatomical parameters were investigated in a multifaceted study. Three groups were formed from Allium bulbs, one of which was the control group. One of the other groups was exposed to 254 nm (UV-C) and the other to 365 nm (UV-A) UV. Growth retardation effect of UV was investigated with respect to germination percentage, total weight gain, and root elongation, while cytogenotoxicity arisen from UV exposure was analyzed using mitotic index (MI) and chromosomal aberration (CA) and micronucleus (MN) frequency. Oxidative stress due to UV application was investigated based on the accumulation of malondialdehyde (MDA) and the total activities of superoxide dismutase (SOD) and catalase (CAT) enzymes. Also, anatomical changes induced by UV-A and UV-C were analyzed in root meristematic cells. UV treatments caused significant reductions in growth-related parameters. Both UV treatments caused a significant increase in MDA levels and induction of SOD and CAT enzymes in root meristematic cells. A decrease in MI and an increase in the frequency of MN and CAs were observed in root tip cells, indicating the cytogenotoxic effect of UV application. Anatomical damages such as epidermis cell damage, cortex cell damage, necrotic zones, giant cell nucleus, and indistinct transmission tissue occurred in cells exposed to UV. All of the physiological, biochemical, cytogenetic, and anatomical damages observed in this study were more severe in cells treated with UV-C compared to UV-A. This study suggested that UV exposure triggered growth inhibition, cytogenotoxicity, oxidative stress, and meristematic cell damages in A. cepa roots depending on the wavelength.

Controlling microbial activity on walls by a photocatalytic nanocomposite paint: A field study

BACKGROUND

Bacteria and fungi that grow on the walls can cause allergic reactions and infectious diseases in human. We proposed a low-cost and easy-to-operate testing protocol for large scale field studies to evaluate the long-term antimicrobial performance of a novel WO_x paint in 2 primary schools.

METHODS

In Tun Mun and Tin Shui Wai schools, WO_x paints were painted on semi-outdoor and indoor walls and daily chlorine disinfection was applied after class in TSW School. A guidance was proposed for the protocol using the ATP biofluorescence method for large-scale field studies. ATP swab samples were taken at locations with and without the WO_x paint on a control basis with a sampling frequency once a week for three months. The ATP values were then processed and presented in box plots.

RESULTS

In both schools, the median log-scale ATP values of walls with WOx paint were at least 0.5-log lower than those without WOx paint. The WO_x paint also performed better than daily chlorine disinfection in reducing microbial activities in long-term.

CONCLUSIONS

The proposed testing protocol is suitable to evaluate long-term performance of an antimicrobial paint by analyzing its microbial activity in large-scale field tests. The WO_x paint shows long-term effectiveness in reducing microbial activities on wall surfaces in both indoor and semi-outdoor environments.

Nanoparticle Engineered Photocatalytic Paints: A Roadmap to Self-Sterilizing against the Spread of Communicable Diseases

Applications of visible-light photocatalytic engineered nanomaterials in the preparation of smart paints are of recent origin. The authors have revealed a great potential of these new paints for self-sterilizing of the surfaces in hospitals and public places simply with visible light exposure and this is reported for the first time in this review. A recent example of a communicable disease such as COVID-19 is considered. With all precautions and preventions taken as suggested by the World Health Organization (WHO), COVID-19 has remained present for a longer time compared to other diseases. It has affected millions of people worldwide and the significant challenge remains of preventing infections due to SARS-CoV-2. The present review is focused on revealing the cause of this widespread disease and suggests a roadmap to control the spread of disease. It is understood that the transmission of SARS-CoV-2 virus takes place through contact surfaces such as doorknobs, packaging and handrails, which may be responsible for many preventable and nosocomial infections. In addition, due to the potent transmissibility of SARS-CoV-2, its ability to survive for longer periods on common touch surfaces is also an important reason for the spread of COVID-19. The existing antimicrobial cleaning technologies used in hospitals are not suitable, viable or economical to keep public places free from such infections. Hence, in this review, an innovative approach of coating surfaces in public places with visible-light photocatalytic nanocomposite paints has been suggested as a roadmap to self-sterilizing against the spread of communicable diseases. The formulations of different nanoparticle engineered photocatalytic paints with their ability to destroy pathogens using visible light, alongwith the field trials are also summarized and reported in this review. The potential suggestions for controlling the spread of communicable diseases are also listed at the end of the review.

UV-C Light-Based Surface Disinfection: Analysis of Its Virucidal Efficacy Using a Bacteriophage Model

Background: The reprocessing of medical devices has become more complex due to increasing hygiene requirements. Previous studies showed satisfactory bactericidal disinfection effects of UV-C light in rigid and flexible endoscopes. Especially in the context of the current COVID-19 pandemic, virucidal properties are of high importance. In the present study, the virucidal efficacy of UV-C light surface disinfection was analyzed. Methods: MS-2 bacteriophages were applied to the test samples and irradiated by UV-C light using the UV Smart D25 device; unirradiated test samples were used as controls. A dilution series of the samples was mixed with 1 × 108 Escherichia coli and assayed. Results: 8.6 × 1012 pfu could be harvested from the unprocessed test samples. In the control group without UV-C exposure, a remaining contamination of 1.2 × 1012 pfu was detected, resulting in a procedural baseline reduction rate with a LOG10 reduction factor of 0.72. The LOG10 reduction factor was found to be 3.0 after 25 s of UV-C light exposure. After 50 and 75 s of UV-C radiation LOG10 reduction factors 4.2 and 5.9, respectively, were found, with all reductions being statistically significantly different to baseline. Conclusions: The tested UV system seems to provide a significant virucidal effect after a relatively short irradiation time.

Wearable Light Sensors Based on Unique Features of a Natural Biochrome

Overexposure to complete solar radiation (combined ultraviolet, visible, and infrared) is correlated with several harmful biological consequences including hyperpigmentation, skin cancer, eye damage, and immune suppression. With limited effective therapeutic options available for these conditions, significant efforts have been directed toward promoting preventative habits. Recently, wearable solar radiometers have emerged as practical tools for managing personal exposure to sunlight. However, designing simple and inexpensive sensors that can measure energy across multiple spectral regions without incorporating electronic components remains challenging, largely due to inherent spectral limitations of photoresponsive indicators. In this work, we report the design, fabrication, and characterization of wearable radiation sensors that leverage an unexpected feature of a natural biochrome, xanthommatin-its innate sensitivity to both ultraviolet and visible through near-infrared radiation. We found that xanthommatin-based sensors undergo a visible shift from yellow to red in the presence of complete sunlight. This color change is driven by intrinsic photoreduction of the molecule, which we investigated using computational modeling and supplemented by radiation-driven formation of complementary reducing agents. These sensors are responsive to dermatologically relevant doses of erythemally weighted radiation, as well as cumulative doses of high-energy ultraviolet radiation used for germicidal sterilization. We incorporated these miniature sensors into pressure-activated microfluidic systems to illustrate on-demand activation of a wearable and mountable form factor. When taken together, our findings encompass an important advancement toward accessible, quantitative measurements of UVC and complete solar radiation for a variety of use cases.

What We Are Learning from COVID-19 for Respiratory Protection: Contemporary and Emerging Issues

Infectious respiratory diseases such as the current COVID-19 have caused public health crises and interfered with social activity. Given the complexity of these novel infectious diseases, their dynamic nature, along with rapid changes in social and occupational environments, technology, and means of interpersonal interaction, respiratory protective devices (RPDs) play a crucial role in controlling infection, particularly for viruses like SARS-CoV-2 that have a high transmission rate, strong viability, multiple infection routes and mechanisms, and emerging new variants that could reduce the efficacy of existing vaccines. Evidence of asymptomatic and pre-symptomatic transmissions further highlights the importance of a universal adoption of RPDs. RPDs have substantially improved over the past 100 years due to advances in technology, materials, and medical knowledge. However, several issues still need to be addressed such as engineering performance, comfort, testing standards, compliance monitoring, and regulations, especially considering the recent emergence of pathogens with novel transmission characteristics. In this review, we summarize existing knowledge and understanding on respiratory infectious diseases and their protection, discuss the emerging issues that influence the resulting protective and comfort performance of the RPDs, and provide insights in the identified knowledge gaps and future directions with diverse perspectives.

UVC-based photoinactivation as an efficient tool to control the transmission of coronaviruses

The ongoing COVID-19 pandemic made us re-realize the importance of environmental disinfection and sanitation in indoor areas, hospitals, and clinical rooms. UVC irradiation of high energy and short wavelengths, especially in the 200-290-nm range possesses the great potential for germicidal disinfection. These properties of UVC allow to damage or destruct the nucleic acids (DNA/RNA) in diverse microbes (e.g., bacteria, fungi, and viruses). UVC light can hence be used as a promising tool for prevention and control of their infection or transmission. The present review offers insights into the historical perspective, mode of action, and recent advancements in the application of UVC-based antiviral therapy against coronaviruses (including SARS CoV-2). Moreover, the application of UVC lights in the sanitization of healthcare units, public places, medical instruments, respirators, and personal protective equipment (PPE) is also discussed. This article, therefore, is expected to deliver a new path for the developments of UVC-based viricidal approach.

Scalable, effective, and rapid decontamination of SARS-CoV-2 contaminated N95 respirators using germicidal ultraviolet C (UVC) irradiation device

Particulate respirators such as N95s are an essential component of personal protective equipment (PPE) for front-line workers. This study describes a rapid and effective UVC irradiation system that would facilitate the safe re-use of N95 respirators and provides supporting information for deploying UVC for decontamination of SARS-CoV-2 during the COVID-19 pandemic. To assess the inactivation potential of the proposed UVC germicidal device as a function of time by using 3 M 8211-N95 particulate respirators inoculated with SARS-CoV-2. A germicidal UVC device to deliver tailored UVC dose was developed and test coupons (2.5 cm2) of the 3 M-N95 respirator were inoculated with 106 plaque-forming units (PFU) of SARS-CoV-2 and were UV irradiated. Different exposure times were tested (0-164 s) by fixing the distance between the lamp and the test coupon to 15.2 cm while providing an exposure of at least 5.43 mWcm-2. Primary measure of outcome was titration of infectious virus recovered from virus-inoculated respirator test coupons after UVC exposure. Other measures included the method validation of the irradiation protocol, using lentiviruses (biosafety level-2 agent) and establishment of the germicidal UVC exposure protocol. An average of 4.38 × 103 PFU ml-1 (SD 772.68) was recovered from untreated test coupons while 4.44 × 102 PFU ml-1 (SD 203.67), 4.00 × 102 PFU ml-1 (SD 115.47), 1.56 × 102 PFU ml-1 (SD 76.98) and 4.44 × 101 PFU ml-1 (SD 76.98) was recovered in exposures 2, 6, 18 and 54 s per side respectively. The germicidal device output and positioning was monitored and a minimum output of 5.43 mW cm-2 was maintained. Infectious SARS-CoV-2 was not detected by plaque assays (minimal level of detection is 67 PFU ml-1) on N95 respirator test coupons when irradiated for 120 s per side or longer suggesting 3.5 log reduction in 240 s of irradiation, 1.3 J cm-2. A scalable germicidal UVC device to deliver tailored UVC dose for rapid decontamination of SARS-CoV-2 was developed. UVC germicidal irradiation of N95 test coupons inoculated with SARS-CoV-2 for 120 s per side resulted in 3.5 log reduction of virus. These data support the reuse of N95 particle-filtrate apparatus upon irradiation with UVC and supports use of UVC-based decontamination of SARS-CoV-2 during the COVID-19 pandemic.

Extenuating role of lycopene against 254-nm UV-C radiation-mediated damages in Allium cepa L. roots

UV-C exposure has become a crucial risk for living organisms due to its widespread use in sterilization. In this study, the mitigating potential of lycopene was investigated against UV-C-mediated toxicity in Allium cepa L. roots. Allium bulbs were separated into six groups which treated with tap water, 215 mg/L lycopene, 430 mg/L lycopene, 254-nm UV radiation, 215 mg/L lycopene + 254-nm UV radiation, and 430 mg/L lycopene + 254-nm UV radiation. Germination percentage, root length, weight gain, mitotic index, micronucleus frequency, and other chromosomal aberrations as well as meristematic cell damages were investigated in all groups. Malondialdehyde level and the activities of superoxide dismutase and catalase enzymes were also analyzed to understand the severity of oxidative stress. UV-C radiation was revealed to negatively affect all parameters investigated, while the mitigating activities of lycopene against UV-C-mediated toxicity were dose-dependent. Therefore, the study evidently demonstrated the promising potential of lycopene in the protection against the detrimental effects of UV-C exposure in A. cepa.

Efficiency of an air circulation decontamination device for micro-organisms using ultraviolet radiation

BACKGROUND

The concern with environmental security to avoid contamination of individuals was intensified with the crisis established by SARS-CoV-2. The COVID-19 pandemic has shown the necessity to create systems and devices capable of clearing the air in an environment of micro-organisms more efficiently. The development of systems that allow the removal of micro-droplets mainly originating from breathing or talking from the air was the motivation of this study.

AIM

This article describes a portable and easy-to-operate system that helps to eliminate the droplets or aerosols present in the environment by circulating air through an ultraviolet-C (UV-C) reactor.

METHODS

An air circulation device was developed, and a proof-of-principle study was performed using the device against bacteria in simulated and natural environments. The microbiological analysis was carried out by the simple sedimentation technique. In order to compare the experimental results and the expected results for other micro-organisms, the reduction rate values for bacteria and viruses were calculated and compared with the experimental results based on technical parameters (clean air delivery rate (CADR) and air changes per hour (ACH)).

FINDINGS

Results showed that the micro-organisms were eliminated with high efficiency by the air circulation decontamination device, with reductions of 99.9% in the proof-of-principle study, and 84-97% in the hospital environments study, contributing to reducing contamination of individuals in environments considered to present risk.

CONCLUSION

This study resulted in a low-cost and relatively simple device, which was shown to be effective and safe, and could be replicated, especially in low-income countries, respecting the standards for air disinfection using UV-C technologies.

Back to Basics: Choosing the Appropriate Surface Disinfectant

From viruses to bacteria, our lives are filled with exposure to germs. In built environments, exposure to infectious microorganisms and their byproducts is clearly linked to human health. In the last year, public health emergency surrounding the COVID-19 pandemic stressed the importance of having good biosafety measures and practices. To prevent infection from spreading and to maintain the barrier, disinfection and hygiene habits are crucial, especially when the microorganism can persist and survive on surfaces. Contaminated surfaces are called fomites and on them, microorganisms can survive even for months. As a consequence, fomites serve as a second reservoir and transfer pathogens between hosts. The knowledge of microorganisms, type of surface, and antimicrobial agent is fundamental to develop the best approach to sanitize fomites and to obtain good disinfection levels. Hence, this review has the purpose to briefly describe the organisms, the kind of risk associated with them, and the main classes of antimicrobials for surfaces, to help choose the right approach to prevent exposure to pathogens.

Ultraviolet-C (UV-C) monitoring made simple: Colorimetric indicators to assess delivery of UV-C light by room decontamination devices

OBJECTIVE

To evaluate the use of colorimetric indicators for monitoring ultraviolet-C (UV-C) light delivery to sites in patient rooms.

METHODS

In laboratory testing, we examined the correlation between changes in color of 2 commercial colorimetric indicators and log10 reductions in methicillin-resistant Staphylococcus aureus (MRSA) and Clostridioides difficile spores with exposure to increasing doses of UV-C from a low-pressure mercury room decontamination device. In patient rooms, 1 of the colorimetric indicators was used to assess UV-C dose delivery to 27 sites in the room.

RESULTS

In laboratory testing, the manufacturer's reference colors for MRSA and C. difficile reduction corresponded with doses of ∼10,000 and 46,000 µJ/cm2; these doses resulted in >3 log10 reductions in MRSA and C. difficile spores, respectively. In patient rooms, the colorimetric indicators demonstrated suboptimal delivery of UV-C dosing to shadowed areas, which was improved by providing cycles on each side of the patient bed rather than in a single position and altering device placement. Increasing duration of exposure increased the number of sites achieving adequate dosing to kill C. difficile spores.

CONCLUSIONS

Commercial colorimetric indicators provide rapid and easy-to-interpret information on the UV-C dose delivered to sites in patient rooms. The indicators may be useful for training environmental services personnel and optimizing the effectiveness of UV-C room decontamination devices.

Service Robots in the Healthcare Sector

Traditionally, advances in robotic technology have been in the manufacturing industry due to the need for collaborative robots. However, this is not the case in the service sectors, especially in the healthcare sector. The lack of emphasis put on the healthcare sector has led to new opportunities in developing service robots that aid patients with illnesses, cognition challenges and disabilities. Furthermore, the COVID-19 pandemic has acted as a catalyst for the development of service robots in the healthcare sector in an attempt to overcome the difficulties and hardships caused by this virus. The use of service robots are advantageous as they not only prevent the spread of infection, and reduce human error but they also allow front-line staff to reduce direct contact, focusing their attention on higher priority tasks and creating separation from direct exposure to infection. This paper presents a review of various types of robotic technologies and their uses in the healthcare sector. The reviewed technologies are a collaboration between academia and the healthcare industry, demonstrating the research and testing needed in the creation of service robots before they can be deployed in real-world applications and use cases. We focus on how robots can provide benefits to patients, healthcare workers, customers, and organisations during the COVID-19 pandemic. Furthermore, we investigate the emerging focal issues of effective cleaning, logistics of patients and supplies, reduction of human errors, and remote monitoring of patients to increase system capacity, efficiency, resource equality in hospitals, and related healthcare environments.

Methods to mitigate infection spread from aerosol-generating dental procedures

Infection control measures play a critical role in preventing the spread of disease in healthcare settings. Concerns that SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), the virus that causes Coronavirus Disease 2019, may be transmitted through droplets and aerosols from both symptomatic and asymptomatic individuals has turned the spotlight on healthcare interventions that involve aerosol generation in the oral cavity, such as many dental and periodontal procedures. This commentary seeks to familiarize the dental practitioner with various infection control methods that may be implemented to mitigate spread of infection in dental settings through aerosol-generating dental procedures.

Exploring the Applicability of Robot-Assisted UV Disinfection in Radiology

The importance of infection control procedures in hospital radiology departments has become increasingly apparent in recent months as the impact of COVID-19 has spread across the world. Existing disinfectant procedures that rely on the manual application of chemical-based disinfectants are time consuming, resource intensive and prone to high degrees of human error. Alternative non-touch disinfection methods, such as Ultraviolet Germicidal Irradiation (UVGI), have the potential to overcome many of the limitations of existing approaches while significantly improving workflow and equipment utilization. The aim of this research was to investigate the germicidal effectiveness and the practical feasibility of using a robotic UVGI device for disinfecting surfaces in a radiology setting. We present the design of a robotic UVGI platform that can be deployed alongside human workers and can operate autonomously within cramped rooms, thereby addressing two important requirements necessary for integrating the technology within radiology settings. In one hospital, we conducted experiments in a CT and X-ray room. In a second hospital, we investigated the germicidal performance of the robot when deployed to disinfect a CT room in <15 minutes, a period which is estimated to be 2-4 times faster than current practice for disinfecting rooms after infectious (or potentially infectious) patients. Findings from both test sites show that UVGI successfully inactivated all of measurable microbial load on 22 out of 24 surfaces. On the remaining two surfaces, UVGI reduced the microbial load by 84 and 95%, respectively. The study also exposes some of the challenges of manually disinfecting radiology suites, revealing high concentrations of microbial load in hard-to-reach places. Our findings provide compelling evidence that UVGI can effectively inactivate microbes on commonly touched surfaces in radiology suites, even if they were only exposed to relatively short bursts of irradiation. Despite the short irradiation period, we demonstrated the ability to inactivate microbes with more complex cell structures and requiring higher UV inactivation energies than SARS-CoV-2, thus indicating high likelihood of effectiveness against coronavirus.

Quantitative UV-C dose validation with photochromic indicators for informed N95 emergency decontamination

With COVID-19 N95 shortages, frontline medical personnel are forced to reuse this disposable-but sophisticated-multilayer respirator. Widely used to decontaminate nonporous surfaces, UV-C light has demonstrated germicidal efficacy on porous, non-planar N95 respirators when all surfaces receive ≥1.0 J/cm2 dose. Of utmost importance across disciplines, translation of empirical evidence to implementation relies upon UV-C measurements frequently confounded by radiometer complexities. To enable rigorous on-respirator measurements, we introduce a photochromic indicator dose quantification technique for: (1) UV-C treatment design and (2) in-process UV-C dose validation. While addressing outstanding indicator limitations of qualitative readout and insufficient dynamic range, our methodology establishes that color-changing dosimetry can achieve the necessary accuracy (>90%), uncertainty (<10%), and UV-C specificity (>95%) required for UV-C dose measurements. In a measurement infeasible with radiometers, we observe a striking ~20× dose variation over N95s within one decontamination system. Furthermore, we adapt consumer electronics for accessible quantitative readout and use optical attenuators to extend indicator dynamic range >10× to quantify doses relevant for N95 decontamination. By transforming photochromic indicators into quantitative dosimeters, we illuminate critical considerations for both photochromic indicators themselves and UV-C decontamination processes.

Increased sanitization potency of hydrogen peroxide with synergistic O3 and intense pulsed light for non-woven polypropylene

Supplies of respiratory masks have recently become a concern due to the onset of the SARS-CoV-2 pandemic. Sanitization and reuse of masks can alleviate high mask consumption and production stresses. In the present work, improved sanitization potency of vaporous hydrogen peroxide (VHP) treatment of resilient bacterial spores while retaining polymeric filter performance was explored. A batch fumigation chamber with hydrogen peroxide (H₂O₂) vapor and ozone (O₃) is featured, followed by intense pulsed light (IPL) flash treatments. A resilient bacterial indicator, Geobacillus stearothermophilus (G. stearothermophilus), was utilized to compare the efficacy of various H₂O₂ concentrations in combination with O₃ and IPL. It was found that exposure to 30 minutes of 4.01 L min⁻¹ 0.03% H₂O₂ aqueous vapor and 3 g h⁻¹ O₃ followed by 10 IPL flashes per side completely inactivated G. stearothermophilus. The xenon sourced IPL irradiation was found to synergistically enhance radical production and strengthen the complementary biocidal interaction of H₂O₂ with O₃. Due to the synergistic effects, H₂O₂ was able to sanitize at a diluted concentration of 0.03% H₂O₂. The physical properties, such as surface potential, tensile strength, hydrophobicity, and filtration efficiency of >300 nm saline water aerosol of fibrous polypropylene (PP) sheets, were maintained. In addition, no residue of sanitizers was detected, thus confirming the biosafety and applicability of this method to disposable masks. Performance was benchmarked and compared with commercially available processes. The synergistic regime was found to achieve sterilization of G. stearothermophilus at drastically reduced H₂O₂ concentrations and in ambient conditions relative to commercial methods.

By introducing synergistic elements to the VHP processes, potent sanitization of polymeric filters is achieved at low H₂O₂ concentrations.

Evaluation of decontamination methods for commercial and alternative respirator and mask materials - view from filtration aspect

This study aims to evaluate the filtration performance of three commercially available (3M 8210 respirator, Halyard 48207 surgical mask, and 3M 1820 procedure mask) and two alternative face mask and respirator materials (Halyard H600 sterilization wrap and Cummins EX101) after selected decontamination treatments, including isopropanol (IPA) treatments (soaking or spraying), ultraviolet germicidal irradiation (UVGI), and heat treatments (dry heat at 77 °C or steam heat). Both IPA soaking and spraying removed most electrostatic charges on all four electret materials (three commercial and one alternative), causing significant deterioration of filtration efficiency to unacceptable level. The other non-electret alternative material sustained its N95-grade performance after both IPA soaking and spraying treatments, demonstrating the possible application of IPA disinfection for non-electret alternative respirator/mask materials. UVGI preserved the filtration of all three commercially available respirator/mask materials after up to 10 treatments, suggesting it can be a possible decontamination method for hospital and clinic use without compromising respirator/mask performance. The considerations of the practical implementation of this method was discussed. Between the two heat treatment methods tested, dry heat showed better compatibility with electret material by sustaining both filtration efficiency and fit (tested on commercial respirator only), although adding moisture was reported in favor of virus inactivation. Heat treatment is easily accessible method for general publics to implement at home, while it is recommended to maintain the moisture level below saturation. Comparing to size-integrated method, the size-resolved fractional efficiency measurement technique, although more time consuming, proved to be a better method for evaluating respirator/mask filtration performance after decontaminations by providing more sensitive detection of performance degradation and the capability of distinguishing charge loss to other mechanisms causing efficiency deterioration. Detailed descriptions are provided in methodology part to emphasize the cares needed for an appropriate efficiency evaluation. The limited results in this study on worn masks made of alternative sterilization wrap indicated possible performance degradation of electret material caused by normal human wearing activities, suggesting the need of assessing respirator/mask decontamination strategy by testing practically worn-and-decontaminated/reused samples instead of unworn only-decontaminated counterparts.

Ultraviolet germicidal irradiation of the inner bore of a CT gantry

PURPOSE

To investigate the feasibility and practicality of ultraviolet (UV) germicidal irradiation of the inner bore of a computed tomography (CT) gantry as a means of viral decontamination.

METHOD

A UV lamp (PADNUT 38 W, 253 nm UV-C light tube) and UV-C dosimeter (GENERAL UV-C Digital Light Meter No. UV512C) were used to measure irradiance throughout the inner bore of a CT scanner gantry. Irradiance (units μW/cm² ) was related to the time required to achieve 6-log viral kill (10^-6 survival fraction).

RESULTS

A warm-up time of ~120 s was required for the lamp to reach stable irradiance. Irradiance at the scan plane (z = 0 cm) of the CT scanner was 580.9 μW/cm² , reducing to ~350 μW/cm² at z = ±20 cm toward the front or back of the gantry. The angular distribution of irradiation was uniform within 10% coefficient of variation. A conservative estimate suggests at least 6-log kill (survival fraction ≤ 10^-6 ) of viral RNA within ±20 cm of the scan plane with an irradiation time of 120 s from cold start. More conservatively, running the lamp for 180 s (3 min) or 300 s (5 min) from cold start is estimated to yield survival fraction <<10^-7 survival fraction within ±20 cm of the scan plane.

CONCLUSION

Ultraviolet irradiation of the inner bore of the CT gantry can be achieved with a simple UV-C lamp attached to the CT couch. Such practice could augment manual wipe-down procedures, improve safety for CT technologists or housekeeping staff, and could potentially reduce turnover time between scanning sessions.

Recommendations, Practices and Infrastructural Model for the Dental Radiology Set-up in Clinical and Academic Institutions in the COVID-19 Era

The pandemic of Coronavirus disease (COVID-19) has emerged as a global catastrophe that is plaguing mankind. In the past eight months since the world discovered about COVID-19, we learned a lot about server acute respiratory syndrome coronavirus 2 (SARS CoV-2) and perhaps there is much more to discover and understand about the virus. With the current understanding of the disease, we assume it will remain in an active state of transmission and progression among the community for a long time. Thus, it is advisable to adopt the disease's prevention protocol in our daily and work routine. During this pandemic patient requiring dental treatment cannot be neglected and the role of dental imaging is crucial in delivering treatment. Hence, this article attempts to provide an evidence-based compilation about the mode of transmission and clinical features of COVID-19. It also throws light on the potential source of disease transmission in the dental radiology setting. In addition, it suggests preventive measures to curb the infection and infrastructural model of the clinical setting that will assist in achieving control over the disease transmission. This article intends to project a strategy about protocols, infrastructure, and daily activities in a dental radiology office that institutions can adopt with modifications according to their local scenario.

Scalable, effective, and rapid decontamination of SARS-CoV-2 contaminated N95 respirators using germicidal ultra-violet C (UVC) irradiation device

IMPORTANCE

Particulate respirators such as N95 masks are an essential component of personal protective equipment (PPE) for front-line workers. This study describes a rapid and effective UVC irradiation system that would facilitate the safe re-use of N95 respirators and provides supporting information for deploying UVC for decontamination of SARS-CoV-2 during the COVID19 pandemic.

OBJECTIVE

To assess the inactivation potential of the proposed UVC germicidal device as a function of time by using 3M 8211 - N95 particulate respirators inoculated with SARS-CoV-2.

DESIGN

A germicidal UVC device to deliver tailored UVC dose was developed and snippets (2.5cm2) of the 3M-N95 respirator were inoculated with 106 plaque-forming units (PFU) of SARS-CoV-2 and were UV irradiated. Different exposure times were tested (0-164 seconds) by fixing the distance between the lamp (10 cm) and the mask while providing an exposure of at least 5.43 mWcm-2.

SETTING

The current work is broadly applicable for healthcare-settings, particularly during a pandemic such as COVID-19.

PARTICIPANTS

Not applicable. Main Outcome(s) and Measure(s): Primary measure of outcome was titration of infectious virus recovered from virus-inoculated respirator pieces after UVC exposure. Other measures included the method validation of the irradiation protocol, using lentiviruses (biosafety level-2 agent) and establishment of the germicidal UVC exposure protocol.

RESULTS

An average of 4.38x103 PFUml-1(SD 772.68) was recovered from untreated masks while 4.44x102 PFUml-1(SD 203.67), 4.00x102 PFUml-1(SD 115.47), 1.56x102 PFUml-1(SD 76.98) and 4.44x101 PFUml-1(SD 76.98) was recovered in exposures 2s,6s,18s and 54 seconds per side respectively. The germicidal device output and positioning was monitored and a minimum output of 5.43 mWcm-2 was maintained. Infectious SARS-CoV-2 was not detected by plaque assays (minimal level of detection is 67 PFUml-1) on N95 respirator snippets when irradiated for 120s per side or longer suggesting 3.5 log reduction in 240 seconds of irradiation.

CONCLUSIONS AND RELEVANCE

A scalable germicidal UVC device to deliver tailored UVC dose for rapid decontamination of SARS-CoV-2 was developed. UVC germicidal irradiation of N95 snippets inoculated with SARS-CoV-2 for 120s per side resulted in 100% (3.5 log in total) reduction of virus. These data support the reuse of N95 particle-filtrate apparatus upon irradiation with UVC and supports use of UVC-based decontamination of SARS-CoV-2 virus during the COVID19 pandemic.

Rapid Review of SARS-CoV-1 and SARS-CoV-2 Viability, Susceptibility to Treatment, and the Disinfection and Reuse of PPE, Particularly Filtering Facepiece Respirators

In the COVID-19 pandemic caused by SARS-CoV-2, hospitals are often stretched beyond capacity. There are widespread reports of dwindling supplies of personal protective equipment (PPE), particularly N95-type filtering facepiece respirators (FFRs), which are paramount to protect frontline medical/nursing staff, and to minimize further spread of the virus. We carried out a rapid review to summarize the existing literature on the viability of SARS-CoV-2, the efficacy of key potential disinfection procedures against the virus (specifically ultraviolet light and heat), and the impact of these procedures on FFR performance, material integrity, and/or fit. In light of the recent discovery of SARS-CoV-2 and limited associated research, our review also focused on the closely related SARS-CoV-1. We propose a possible whole-of-PPE disinfection solution for potential reuse that could be rapidly instituted in many health care settings, without significant investments in equipment.

UV-C decontamination for N95 emergency reuse: Quantitative dose validation with photochromic indicators

With COVID-19 N95 respirator shortages, frontline medical personnel are forced to reuse this disposable - but sophisticated - multilayer textile respirator. Widely used for decontamination of nonporous surfaces, UV-C light has germicidal efficacy on porous, non-planar N95 respirators when ≥1.0 J/cm^2 dose is applied across all surfaces. Here, we address outstanding limitations of photochromic indicators (qualitative readout and insufficient dynamic range) and introduce a photochromic UV-C dose quantification technique for: (1) design of UV-C treatments and (2) in-process UV-C dose validation. Our methodology establishes that color-changing dosimetry can achieve the necessary accuracy (>90%), uncertainty (<10%), and UV-C specificity (>95%). Furthermore, we adapt consumer electronics for accessible quantitative readout and extend the dynamic range >10× using optical attenuators. In a measurement infeasible with radiometers, we observe striking 20× dose variation over 3D N95 facepieces. By transforming photochromic indicators into quantitative dosimeters, we illuminate critical design considerations for both photochromic indicators and UV-C decontamination.

Ultraviolet-C and other methods of decontamination of filtering facepiece N-95 respirators during the COVID-19 pandemic

During global health emergencies such as the current COVID-19 pandemic, the decontamination of single-use personal protective equipment (PPE) becomes a necessary means to keep up with the growing demand from healthcare workers and patients alike. Many unverified methods are being considered, which can pose the risk of incomplete decontamination and lead to catastrophic results. Several factors come into play when determining the suitability of such methods including the quality of the decontamination technique, the targeted pathogen, cost, ease of installation and use, rate of sterilization, and the surface or material to be sterilized. The germicidal properties of ultraviolet-C are well known. This review will cover the most commonly described methods for the sterilization of N95 respirators, namely, ultraviolet germicidal irradiation, hydrogen peroxide vaporization, microwave-generated steaming, and dry heating. These techniques have been tested previously and have demonstrated efficacy in reducing or inactivating viral and bacterial pathogens, although testing against SARS-CoV-2 specifically has not been done. Moreover, it must be emphasized that proper disposal after a single use is still ideal under normal circumstances.

Covid-19 Pandemic: What Changes for Dentists and Oral Medicine Experts? A Narrative Review and Novel Approaches to Infection Containment

The authors performed a narrative review on Severe Acute Respiratory Syndrome- CoronaVirus-2 ( SARS-CoV-2) and all infectious agents with the primary endpoints to illustrate the most accepted models of safety protocols in dentistry and oral medicine, and to propose an easy view of the problem and a comparison (pre- vs post-COVID19) for the most common dental procedures. The outcome is forecast to help dentists to individuate for a given procedure the differences in terms of safety protocols to avoid infectious contagion (by SARS-CoV-2 and others dangerous agents). An investigation was performed on the online databases Pubmed and Scopus using a combination of free words and Medical Subject Headings (MESH) terms: "dentist" OR "oral health" AND "COVID-19" OR "SARS-CoV-2" OR "coronavirus-19". After a brief excursus on all infectious agents transmittable at the dental chair, the authors described all the personal protective equipment (PPE) actually on the market and their indications, and on the basis of the literature, they compared (before and after COVID-19 onset) the correct safety procedures for each dental practice studied, underlining the danger of underestimating, in general, dental cross-infections. The authors have highlighted the importance of knowing exactly the risk of infections in the dental practice, and to modulate correctly the use of PPE, in order to invest adequate financial resources and to avoid exposing both the dental team and patients to preventable risks.

Germicidal Ultraviolet Light Does Not Damage or Impede Performance of N95 Masks Upon Multiple Uses

The COVID-19 pandemic is increasing the need for personal protective equipment (PPE) worldwide, including the demand for facial masks used by healthcare workers. Disinfecting and reusing these masks may offer benefits in the short term to meet urgent demand. Germicidal ultraviolet light provides a nonchemical, easily deployable technology capable of achieving inactivation of H1N1 virus on masks. Working with N95-rated masks and nonrated surgical masks, we demonstrated that neither 254 nor 265 nm UV-C irradiation at 1 and 10 J/cm2 had adverse effects on the masks' ability to remove aerosolized virus-sized particles. Additional testing showed no change in polymer structure, morphology, or surface hydrophobicity for multiple layers in the masks and no change in pressure drop or tensile strength of the mask materials. Results were similar when applying 254 nm low-pressure UV lamps and 265 nm light-emitting diodes. On the basis of the input from healthcare workers and our findings, a treatment system and operational manual were prepared to enable treatment and reuse of N95 facial masks. Knowledge gained during this study can inform techno-economic analyses for treating and reusing masks or lifecycle assessments of options to reduce the enormous waste production of single-use PPE used in the healthcare system, especially during pandemics.

Spectrum of virucidal activity from ultraviolet to infrared radiation

The COVID-19 pandemic has sparked a demand for safe and highly effective decontamination techniques for both personal protective equipment (PPE) and hospital and operating rooms. The gradual lifting of lockdown restrictions warrants the expansion of these measures into the outpatient arena. Ultraviolet C (UVC) radiation has well-known germicidal properties and is among the most frequently reported decontamination techniques used today. However, there is evidence that wavelengths beyond the traditional 254 nm UVC - namely far UVC (222 nm), ultraviolet B, ultraviolet A, visible light, and infrared radiation - have germicidal properties as well. This review will cover current literature regarding the germicidal effects of wavelengths ranging from UVC through the infrared waveband with an emphasis on their activity against viruses, and their potential applicability in the healthcare setting for general decontamination during an infectious outbreak.